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Revenue Recognition Segment revenue by major payor (Tables)
3 Months Ended
Mar. 31, 2021
Revenues by major payor [Abstract]  
Disaggregation of Revenue [Table Text Block]
The following table summarizes the Company's segment revenues by primary payor source:
Three months ended March 31, 2021Three months ended March 31, 2020
U.S. dialysisOther - Ancillary servicesConsolidatedU.S. dialysisOther - Ancillary servicesConsolidated
Dialysis patient service revenues:
Medicare and Medicare Advantage(1)
$1,480,297 $$1,480,297 $1,531,033 $$1,531,033 
Medicaid and Managed Medicaid187,243 187,243 171,467 171,467 
Other government(1)
80,184 106,830 187,014 83,099 94,574 177,673 
Commercial835,479 51,498 886,977 825,582 39,467 865,049 
Other revenues:
Medicare and Medicare Advantage85,595 85,595 98,478 98,478 
Medicaid and Managed Medicaid300 300 366 366 
Commercial6,034 6,034 10,521 10,521 
Other(2)
6,675 11,162 17,837 5,442 17,602 23,044 
Eliminations of intersegment revenues(27,003)(4,293)(31,296)(32,242)(4,152)(36,394)
Total$2,562,875 $257,126 $2,820,001 $2,584,381 $256,856 $2,841,237